MIKLA DERLET (Credential# 1493105) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is May 1, 2019. The license expiration date date is April 30, 2020. The license status is ACTIVE.
MIKLA DERLET is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.061833. The credential type is physician/surgeon. The effective date is May 1, 2019. The expiration date is April 30, 2020. The business address is Po Box 739, Twain Harte, CA 95383. The current status is active.
| Licensee Name | MIKLA DERLET |
| Credential ID | 1493105 |
| Credential Number | 1.061833 |
| Credential Type | Physician/Surgeon |
| Business Address |
Po Box 739 Twain Harte CA 95383 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2018-08-27 |
| Effective Date | 2019-05-01 |
| Expiration Date | 2020-04-30 |
| Refresh Date | 2019-04-22 |
| Street Address | PO BOX 739 |
| City | TWAIN HARTE |
| State | CA |
| Zip Code | 95383 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| John R Williams | 18518 Story Lane, Twain Harte, CA 95383 | Pharmacist | 1997-02-01 ~ 1998-01-31 |
| City | TWAIN HARTE |
| Zip Code | 95383 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + TWAIN HARTE |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Julie Mikla | 4 Berkshire Blvd., Bethel, CT 06801 | Medication Administration Certification | 1996-04-02 ~ 1998-04-01 |
| Penny Lamhut Md | Genesis Physician Services, Windsor, CT 06098 | Physician/surgeon | 1999-07-15 ~ 2000-07-31 |
| Gilbert L Drozdow | Envision Physician Services, Plantation, FL 33322 | Physician/surgeon | 2019-10-01 ~ 2020-09-30 |
| Russell H Harris Md | Envision Physician Services, Horsham, PA 19044 | Physician/surgeon | 2019-09-01 ~ 2020-08-31 |
| Arnold R Kriegstein | College Physician, New York, NY 10032 | Physician/surgeon | 1993-04-23 ~ 1994-03-31 |
| John T Thompson | Physician Pavilion W, Towson, MD 21204 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Catherine Nguyen Keegan | Envision Physician Services, Dallas, TX 75240 | Physician/surgeon | 2020-02-01 ~ 2021-01-31 |
| Brent Robert Jacobson | Envision Physician Services, Dallas, TX 75240 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Nazanin Barzideh Md | North Shore Retina Physician, Pllc, East Hills, NY 11576 | Physician/surgeon | 2010-05-01 ~ 2011-04-30 |
| Barbara A Brandes Md | Danbury Office of Physician Services, Danbury, CT 06810 | Physician/surgeon | 2004-07-08 ~ 2005-07-31 |
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| Data Provider | Connecticut Department of Consumer Protection |
| Jurisdiction | Connecticut |
| Related Datasets | Connecticut Business Registrations, Connecticut Child Care Facilities |
This dataset includes 1.41 million licenses issued wtih Connecticut Department of Consumer Protection (TDLR).